Basic Information
Provider Information
NPI: 1972676195
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SINKHORN
FirstName: CLARENCE
MiddleName: PAUL
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: SINKHORN
OtherFirstName: C. PAUL
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: MD
OtherLastNameType: 1
Mailing Information
Address1: 2642 MARLEY DR
Address2:  
City: RIVERSIDE
State: CA
PostalCode: 925064565
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 400 N PEPPER AVE
Address2:  
City: COLTON
State: CA
PostalCode: 923241801
CountryCode: US
TelephoneNumber: 9095806320
FaxNumber:  
Other Information
ProviderEnumerationDate: 11/16/2006
LastUpdateDate: 11/18/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207V00000XG60133CAY Allopathic & Osteopathic PhysiciansObstetrics & Gynecology 

No ID Information.


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